Development of Agile Scrum Perception Tool to Evaluate Students' Opinions on Agile Methodology in Nursing Education.

Background and Aim: Agile methodology (AM) is an innovative, active, team-based learning method that enhances higher-order thinking (metacognitive ability), collaboration, hands-on training, and student engagement in the classroom and clinical environment. Exploring the student's opinions of AM in teaching helps understand how agile can be utilized in higher education to positively improve learning ability, leadership, and teamwork. Hence, the study aimed to develop the agile scrum perception tool (ASPT) to evaluate the opinions on AM among nursing students. Materials and Methods: A cross-sectional design was carried out to develop ASPT in different phases. The tool was initially derived from focus group discussion and literature review. The preliminary draft was revised and modified based on expert review and suggestions by content and construct validity. Reliability was calculated in terms of internal consistency. The developed tool was evaluated using data from 200 4th-year nursing students. Results: A total of 23 items of ASPT have adequate psychometric properties in terms of reliability and validity. Internal consistency was checked by coefficient alpha, which was 0.87. Construct validity was analyzed by factor analysis; all items were loaded in 6 factors, accounting for 54% of the variance in the total ASPT score. Conclusion: ASPT has good validity, reliability, and broader scope in medical and allied education related to project management, clinical teaching, and classroom teaching.

Effectiveness of agile methodology on metacognitive ability, and clinical performance among nursing students-An interventional study.

BACKGROUND: The emerging trend focuses on the need for an active agile method in the nursing curriculum. It helps to improve student engagement, the interaction between the students and teachers, higher-order thinking, teamwork, and practical skills. This study was done to assess the effectiveness of agile methodology on metacognitive ability and clinical performance among nursing students. MATERIAL AND METHODS: In this interventional study, two groups of the pre-post design were adopted. Each college was considered a cluster. By using the chit method, the colleges (four) were randomly selected for the experimental and control groups. To avoid contamination, all the fourth-year students were included either in the experimental group (133) or the control groups (132), respectively. The pretest was conducted using a metacognitive awareness inventory (metacognitive ability (MA)) and an objective structured clinical examination (OSCE) tool (clinical performance (CP)) in the experimental and control groups. Leaders were selected using leader attribute inventory (leadership ability (LA) in the pretest and posttest 2 among the experimental and control groups before the agile teaching. By using agile methodology, the newborn course was taught for 21 days in the experimental group. To assess the effectiveness of agile methodology, the control group was not given any teaching. Posttests were conducted immediately and after 1 week to assess the MA and CP in the experimental and control groups. The control group had agile training for 10 days after the posttests to understand the newer agile methodology. The data were analyzed by using SPSS version 28. Descriptive and inferential statistics were used to assess the data for effectiveness. RESULTS: The result showed that there is an improvement in the metacognitive ability (MA) score and clinical performance score over time in the experimental group (P < 0.001). CONCLUSION: The study finding supports that incorporating agile methodology in education impacts the metacognitive ability and clinical performance among nursing students. However, the teacher must be familiar with the methodology while incorporating agile in teaching.

A descriptive analysis of antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in India.

The World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and develop new antimicrobials. Antimicrobial resistance (AMR) patterns of WHO PPL in a tertiary health care facility in Southern India were explored to understand the local priority pathogens. Culture reports of laboratory specimens collected between 1st January 2014 and 31st October 2019 from paediatric patients were extracted. The antimicrobial susceptibility patterns for selected antimicrobials on the WHO PPL were analysed and reported. Of 12,256 culture specimens screened, 2335 (19%) showed culture positivity, of which 1556 (66.6%) were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%), followed by Staphylococcus aureus (16%). Total of 72% of E. coli were extended-spectrum beta-lactamases (ESBL) producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins due to ESBL, and 53% of Staph. aureus were Methicillin-resistant. The analysis showed AMR trends and prevalence patterns in the study setting and the WHO-PPL document are not fully comparable. This kind of local priority difference needs to be recognised in local policies and practices.

Usage of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT/GeneXpert) test as diagnostic modality for pediatric tuberculosis; case series from Mangalore, South India.

BACKGROUND: Diagnosis of Tuberculosis in children is challenging. Hereby we report a case series of 4 patients where Cartridge Based Nucleic Acid Amplification Test (CB NAAT) helped us in early diagnosis. CASE CHARACTERISTICS: Case 1 was a 14-year old girl who was on anti-tuberculous therapy (ATT) for 2 months without any improvement; sputum CBNAAT detected multi-drug resistant tuberculosis (MDR-TB). Case 2 was a 9-year old boy with history and examination findings suggestive of meningitis; CB-NAAT of the cerebrospinal fluid (CSF) was positive. Case 3 was a 1-year old child having fever, cough of 1 month duration with Mantoux positive. CB-NAAT of gastric lavage was positive. Case 4 was a 3- month old child who presented with severe respiratory distress of 11 days duration. Chest x-ray showed miliary mottling; CB-NAAT of gastric lavage was positive. CONCLUSION: CB-NAAT testing was very useful in making an early and definitive diagnosis of tuberculosis, including MDR-TB.

Management practices of tuberculosis in children among pediatric practitioners in Mangalore, South India.

INTRODUCTION: In spite of having BCG vaccination and tuberculosis control program for the last 50 years, prevalence of tuberculosis continues to be high in India. Inadequate diagnostic methods, suboptimal treatment and monitoring, and the lack of vigilant reporting system are some of the contributing factors for the failure of TB control. OBJECTIVES: To know the current practices among local pediatricians regarding management of TB. MATERIALS AND METHODS: Field based cross sectional study. All the registered pediatricians who were practicing in Mangalore, (list - local IAP branch) were included in the study. A structured Questionnaire on signs and symptoms of TB, diagnosis, strategies adopted in treatment, MDR tuberculosis and reporting of cases to RNTCP was asked. Management practice standards according to the Updated National Guidelines for Pediatric Tuberculosis in India, 2012, RNTCP guidelines in consensus with IAP, latest at the time of the study. RESULTS: 50 pediatricians participated in the study with 62% having an attachment to the teaching institution. More than 50% identified all the symptoms of TB. 64% were sending chest X-ray, Mantoux test and gastric lavage/induced sputum examination for AFB to diagnose TB. 22% were not stressing for AFB examination. Still 16% told serological tests as one of the diagnostic modality. 52% were not aware about the diagnosis of latent TB. In 16% of their cases ATT was on a trial basis. Only 52% of the clinicians are adhering to updated national (RNTCP) guidelines. 30% felt still there are drawbacks in the current RNTCP guidelines. 72% knew the correct definition of MDR tuberculosis. But only 36% of them knew the diagnostic method (gene expert/CB NAAT) of confirming the MDR TB. CONCLUSION: Management practices are found to be still suboptimum. Better engagement of the private sector is urgently required to improve TB management practices and to prevent diagnostic delay and drug resistance.

Parents perception on pattern and effects of usage of electronic devices among school going children

Background: Over usage of electronic gadgets has a serious impact on physical activity of children leading to obesity, depression, anxiety, poor scholastic performance, strain on the eyes and triggering factor for' neck and back pain (due to spondylitis).It is very important to know how to control the screen time of children by parents.Methods: Here, 75 parents were subjected to questionnaire study which contained questions on the information on usage of electronic devices among children and the adverse effects noticed. Results were analyzed using Microsoft excel software.Results: Almost all the 75 cases had access to television, 64 had access to smart phones, 24 had access to IPAD/Tablet, 8 had access to laptop and 4 had access to gaming console. It was found that 45 % were depressed / anxious when gadgets were withdrawn from them. 21 kids had no idea what to do when gadgets were not available. 54 kids had no interest in outdoor playing and 38 children were found to have decreased interaction with other family members.Conclusions: Exposure to gadgets in paediatrics population leads to poor scholastic performance, obesity, depression, decreased interaction with family and many other problems. So, it is very important to have control on child's day to day activities and have constant vigilance on their gadget usage.

Clinical and laboratory profile of children with dengue fever admitted at a tertiary care hospital in Mangalore, Karnataka, India: a retrospective study

Background: Dengue fever caused by dengue virus is a self-limiting acute febrile illness transmitted by Aedes aegypti, a daytime biting mosquito. Dengue virus belongs to family of Flaviviridae and there are 4 serotypes. A fifth serotype DENV-5 was isolated in 2013 which was said to cause mild form of the disease. In 2019 total numbers of dengue cases are 10,524 in Karnataka which is 138% increase over 2018 (4,427 cases).Methods: A retrospective conducted in Yenepoya Medical College hospital from January 2017 to July 2019 for a period of 2' years. Medical records of children who were diagnosed with dengue fever were retrieved and analyzed. Clinical and laboratory findings were noted down. Clinical course and outcome were noted down from the case sheet and cases were classified as per WHO 2011 classification.Results: 97 children diagnosed with dengue fever were included in the study. Common age group was 5-15 years. 49.5% had dengue fever, 40.2% had dengue haemorrhagic fever (DHF) and 10.3% had expanded dengue syndrome. Fever was the main complaint. Children with dengue fever presented with vomiting, abdominal pain, myalgia, arthralgia in descending order of frequency. Children with DHF, petechiae were seen in 38% patients. Among bleeding manifestations, epistaxis was more common. Children with expanded dengue syndrome had atypical manifestations.Conclusions: Dengue fever like any other viral illness, presents with prodromal symptoms which should be picked up at the earliest with high index of suspicion in children coming from endemic area. Identification of atypical manifestations and co-infections at the earliest and prompt treatment avoids serious life-threatening complications.

Association of cord blood and maternal lipid profile

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity with dyslipidemia as an important contributing risk factor. Objective of the study was to determine whether there is an association between maternal lipid profile and the cord blood lipid profile of their newborns.Methods: This was a hospital-based Cross-sectional study on 60 mothers and their respective newborns (30 term and 30 preterm) conducted in Yenepoya medical college hospital from August to November 2019. Umbilical cord blood samples from the newborns were collected after birth and the mother's venous blood was collected in the fasting state (8hrs of fasting) before delivery. The levels of total cholesterol, triglycerides, HDL, LDL and VLDL were determined in mothers and their newborns by an enzymatic colorimetric method. Data obtained was analyzed by the SSPS software 23.0 version and Pearson's correlation was done.Results: There was a significant correlation between the mean concentration of maternal Triglycerides and the Triglycerides and HDL levels of neonates (p-value <0.05).Conclusions: There was a significant association of cord blood and maternal lipid profile, hence changes in maternal lipid levels might influence the lipid levels in the cord blood of newborns.

Awareness of human papilloma virus vaccine among medical interns in tertiary health centre

Background: Human Papilloma virus [HPV] infection is one of the most common sexually transmitted disease[STD] in the entire world. In India, HPV infections stands as one of the first few major cause of STD among both male and female adolescents and adults. However studies done in major centers reveals that awareness about this disease among the general population is poor. Aim of this study was the awareness of HPV and its preventive measures among medical interns who have recently completed their graduation and doing medical internship in a tertiary care centre.Methods: Total 100 participants were subjected to questionnaire study which has questions on basic knowledge about HPV and its preventive measures. The data were analyzed using Microsoft excel software.Results: Statically 98% of the study population was aware of HPV, whereas 78% were having knowledge about the vaccine availability for prevention of HPV and only 55% of them knew that the vaccine is available for use in India.Conclusions: Although majority of participants are having knowledge about HPV, the awareness on vaccine and its potentials are very poor. It is very important to put more emphasis on educating medical, nursing, para medical students and interns of various discipline on HPV infection and its preventive measures.

Knowledge, attitude and practice regarding diarrhoea and its prevention and the use of oral rehydration therapy among mothers of children under the age of five visiting a tertiary care hospital in Mangalore, India

Background: Diarrheal diseases remain the second most leading cause of mortality and morbidity next to pneumonia among under-five mortality globally, contributing to 1/5th of child deaths.Methods: Cross sectional hospital based questionnaire study conducted among 200 mothers of children within the age group of 6-60 months with diarrhoea attending the paediatric outdoor or treated in the paediatric indoor (OPD) at YMCH hospital using personal interview method. Filled up questionnaires was collected and was attached along with the filled up proforma.Results: Of 200 mothers, 24.3% knew the correct meaning of diarrhoea, with 73.8% of them not knowing the correct cause of diarrhoea. Only 44.3% knew that it could be prevented. Majority 88.7% did not know to look for signs of dehydration. Less than half of the mothers had only heard of ORT. By using c2-test, preparation ORS was found to be associated with the mother's education (p=0.04) proving that knowledge is better among those mothers with formal education. No association was found between ORS preparation and age of the mother (p=0.229), religion (p=0.342), and gender of the child (p=0.061).Conclusions: The findings of this research indicate that only 73.8% of the mothers had knowledge regarding the cause of the diarrhoea and less than half 11.3% has only heard and used ORT properly.

Clinical study of anemia in rural school children of Mangalore, Karnataka, India

Background: The study was conducted to know the prevalence of anemia in rural school children located within 15km radius of Yenepoya Medical college hospital, Mangalore and to study the risk factors associated with anemia also to correlate the detection of anemia by clinical examination and by lab estimation of hemoglobin.Methods: A total of 550 children in the age group of 6-15 years were included in this study. Parental informed consent was obtained. A preplanner questionnaire was used to collect the health and socio demographic details. Blood was collected by venepuncture method and haemoglobin was determined by automated sysmex machine. Diagnosis of anemia was made according to WHO cut off value of Hb.Results: Out of 550 children 114(20.6%) were anemic. There was no significant difference between age and sex. Anemia was found to be more prevalent in children with h/o passing worms, undernourished, pica and low socio-economic status. Out of 550 children 174 children had conjunctival pallor on clinical examination. Among that 58 (33.3%) children had anemia on hemoglobin estimation. Majority of the children 116 (66.7%) who had pallor on clinical examination was found as non-anemic on hemoglobin estimation. On kappa co efficient, statistics showed that two examinations to detect anemia was 18.47 %, which indicates poor agreement.Conclusions: The overall prevalence of anemia among rural population is variable depending upon the region. Major factors which influence the prevalence of anemia were nutrition, socioeconomic status, pica and worm infestation. Clinical diagnosis by examination of pallor is poorly correlated by estimation of haemoglobin, hence anemia cannot be diagnosed by detection of pallor alone and it requires lab haemoglobin estimation to prevent wrong diagnosis of anemia.